Honourable ministers, distinguished panellists, ladies and gentlemen,
I welcome the emphasis this session is giving to the role of capacity-building in public health as a means of upholding the right to health.
As stated in the WHO Constitution, “Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures.”
The ability to perform this duty of care depends absolutely on having fundamental health capacities in place.
Examples of these capacities include the provision of essential preventive and curative health services and medicines, adequate numbers of health facilities located close to people’s homes, and sufficient numbers of appropriately trained and motivated health staff.
Countries also need the statistical data from information systems that record births, deaths, and causes of death. Data on what diseases and conditions are killing people are essential for setting priorities and designing targeted preventive strategies. Civil registration is essential to ensure that each child has a legal identity and the rights and entitlements this confers.
The provision of adequate health and social measures includes surveillance systems that catch outbreaks quickly, when the chances of containment are greatest, and detect diseases early, when the chances of successful management are best.
The right to health depends on regulatory authorities that keep water, air, food, and medicines safe, and protect populations from exposure to harmful chemicals. The right to health depends on legislation and its enforcement in multiple other ways. Legislation can protect against discrimination and exclusion, and help ensure that all people have an equal opportunity to enjoy the highest attainable level of health.
Laws help ensure that people with a physical or mental disability are not deprived of their liberty or legal capacity. Legislation is one of the best ways to confer population-wide protection against threats to health. Population-wide approaches provide an equal opportunity shield aimed at protecting everyone.
The obvious example is the WHO Framework Convention on Tobacco Control. Legislation that raises the price of tobacco products, bans all forms of advertising and promotion, and provides hard-hitting information on harms to health has a well-documented impact on reducing tobacco use. WHO has also issued guidance on legislation that can reduce the harmful use of alcohol and protect children from the marketing of unhealthy foods and beverages.
WHO has developed other instruments and mechanisms that contribute to fair access to care and thus underpin the right to health, most notably by making the prices of pharmaceutical products more affordable.
We know the capacities that work best to uphold the right to health. However, building these capacities is not at all easy.
The determinants of health, and of the right to health, are exceptionally broad. They include the behaviours of people and parliamentarians, of extremely mobile populations, including refugees and migrants, and extremely volatile pathogens that constantly deliver surprises.
They include international instruments of finance and trade, industries that market unhealthy products, and climate variables increasingly expressed as extreme weather events, whether droughts or floods.
The health situation is marked by extremes. The world has 800 million chronically hungry people, but it also has countries where more than 70% of the adult population is overweight or obese.
This is a world where the price of some generic medicines has dropped so low that manufacturers have left the market, creating holes in the availability of essential medicines. This is also a world in which the costs of some new medicines, especially for chronic conditions, are unaffordable, even for the richest countries in the world.
In some South American countries, the cost of treating a single women with breast cancer, using a drug included on the WHO model list of essential medicines, is equivalent to nearly twice the annual per capita income.
Despite remarkable recent progress, an estimated 5.9 million children died before their fifth birthday in 2015. The millions of young deaths that could have been prevented or cured by existing medical products would be unthinkable in a fair and just world.
The world is neither. An estimated two billion people have no access to essential medicines, effectively shutting them off from the benefits of advances in modern medicine and science. These people will not enjoy the right to health.
Ladies and gentlemen,
A respect for the right to health is a hallmark of good government.
Countries that have enshrined the right to health in their constitutions generally have the best human rights records. Fragile states disrupted by armed conflict generally have the worst records, especially when political factions use the denial of international health assistance as a weapon of war.
As I look back on health development over the past ten years, I am pleased by the consistent emphasis WHO has given to the principles of fairness and equality in access to care.
I am pleased by the worldwide movement towards universal health coverage that was launched by the 2010 World Health Report and is now embedded as a target in the 2030 Agenda for Sustainable Development.
A health system oriented towards universal health coverage leaves no one behind. Since UHC protects against financial hardship caused by paying for essential health care, it also operates as a significant poverty reduction strategy and thus a nation-building strategy.
UHC is the ultimate expression of fairness. It is one of the most powerful social equalizers among all policy options.
At a time when policies in so many sectors are increasing social inequalities and denying the right to health, it is especially gratifying to see health lead the world towards greater fairness in ways that matter to each and every person on this planet.
Thank you.